Penn Medicine Study Examines Use of Yoga to Lessen Side Effects of Prostate Cancer Treatment

More men willing to take part in yoga therapy than anticipated

PHILADELPHIA — A new, first-of-its-kind study by researchers at the Perelman School of Medicine at the University of Pennsylvaniaseeks to learn whether men with prostate cancer who are undergoing radiation therapy can benefit from yoga. The study, led by Neha Vapiwala, MD, associate professor and chief of the Genitourinary Service in the department of Radiation Oncology in Penn's Abramson Cancer Center, is examining the effect of yoga on cancer- and radiation-related fatigue, stress levels, and patients’ quality of life during radiation therapy.

“There are many yoga therapy-related programs in operation, primarily involving women with breast cancer, but ours is the first that we’re aware of that deals exclusively with men with prostate cancer,” said Vapiwala. Nearly 240,000 men are diagnosed with the disease each year in the United States, according to the American Cancer Society, which is funding the new study.

The first goal of the study was to evaluate the feasibility of using yoga as a treatment option for symptom and treatment side effect management among prostate cancer patients. National statistics indicate that 72 percent of those who practice yoga are female, and only 18 percent of practitioners are over the age of 55. The median age at diagnosis for cancer of the prostate is 66.

“We’ve been very pleasantly surprised,” said Vapiwala. “Based on typical yoga gender and age demographics, we thought we would have only about a one-in-five rate of men undergoing radiation therapy being willing and able to participate in yoga classes. So far, it has actually been almost four out of every five patients we ask. This finding alone is important because it’s a caution against making assumptions about patients without proper evidence.”

The second phase of the study, a formal comparison between the study group (men undergoing radiation therapy and taking part in a formal yoga program) and a control group (men receiving radiation therapy but not in any structured yoga program) will began in early 2014. The research team aims to enroll about 60 men in the trial.

The effect of yoga will be measured by participants’ responses to a series of questions that assess such issues as overall quality-of-life, cancer–related fatigue, and prevalence of sexual and erectile dysfunction and urinary incontinence. “We chose these variables because they affect so many prostate cancer patients,” said Vapiwala.

Cancer–related fatigue differs from everyday-life fatigue, which is usually temporary and can be relieved by rest or sleep. Fatigue that stems from cancer or the treatments for the disease has been found to lower patients’ quality of life even more than pain, and studies have shown that between 60 and 90 percent of those receiving radiation therapy report this symptom. Erectile dysfunction is reported in 21 percent to 85 percent of all prostate cancer patients, while urinary incontinence is reported in 24 percent of men with the disease.

“If the results show that taking part in yoga improves quality of life by reducing these problems, we’ll be better able to educate patients on the benefits of yoga that we were not previously aware of, and encourage it among all of our patients,” Vapiwala said.

Yoga programming for the study will consist of twice-weekly classes of 75 minutes each, taught by a trained Eischens yoga instructor within the Abramson Cancer Center. Eischens yoga incorporates ideas from movement theory and kinesiology and is accessible to all body types and experience levels; it is less concerned with achieving complex, body-contorting poses favored by those who pursue yoga for fitness. The simplified poses to be used in this study include seated using a chair, standing, and reclining. Yoga poses will be modified as necessary based on each participant’s needs and restrictions.

The trial represents an expansion of the Abramson Cancer Center’s integrative medicine and wellness services that are available to patients and survivors. In addition to yoga, patients may receive training in stress-reduction techniques, meditation, reiki therapy, acupuncture, and massage. “We offer several ways to enhance quality of life, minimize or reduce side effects of cancer and cancer treatment, and promote healing and recovery,” said Vapiwala. “This study represents one of many research projects we are conducting in an effort to pinpoint the best, most effective practices to help patients with these needs.”

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2013, Penn Medicine provided $814 million to benefit our community.